Best Orthopedic EMR Software

EMR Software

Orthopedic and sports medicine practices have to tackle multiple challenges daily. They are always working to speed up patient encounters, reduce expenses, increase productivity, and improve patient care. But with the rapid pace of patient visits, they need to have top-notch Orthopedic EHR features that support their practice and help them offer optimal care.

Here are the best orthopedic EMR vendors in the market that orthopedists should check out while selecting an EMR company for their organization.

  1. Athenahealth EMR Software
  2. EpicCare Software
  3. drChrono EMR Software
  4. AdvancedMD EHR Software
  5. PrognoCIS EMR Software
  6. ChartLogic EMR Software

1. Athenahealth EMR Software

Athena

Named 2020 Best in KLAS for Small Practice Ambulatory EMR/PM (10 or Fewer Physicians) and Ambulatory RCM Services, athenahealth is a cloud-based electronic medical record, practice management, and medical billing software. Key features include revenue cycle management, care coordination, e-prescribing, population health management, Epocrates, and other point-of-care mobile apps. It comes with an integrated practice management module that simplifies the administrative and medical billing operations of orthopedic practices.

The platform currently works with a network of over 160,000 healthcare providers. It comes with a homepage feature that allows users to manage orders, review patient information, and view incoming lab results. athenahealth’s billing module features a continuously updated rules engine and can be used in tandem with the EHR or on its own. Other practice management tools include custom benchmarking, visibility into daily responsibilities, proactive trend analysis, and more.

2. EpicCare Software

EPIC

EpicCare by Epic Sytems is a health recording solution for large healthcare systems and hospitals. The software comes with robust functionalities and features, a user-friendly interface, sophisticated workflow, a combination of chart review, order management, and documentation. It is certified for Meaningful Use Stages 1 and 2. EpicCare offers dashboards that display and combine clinical financial metrics as well as customizable templates. Specially designed for hospitals with 50-100 healthcare subspecialties and fields, this EMR solution simplifies workflows, improves healthcare delivery, and help physicians track invoices, bills, and payments. Not only this, but the system also provides e=prescribing features and patient portal as a part of Meaningful Use Stage 2 requirements.

The platform supports telemedicine features that help doctors offer virtual care during these testing times. EpicCare is regarded as a mobile EMR solution as it enables patients and physicians to access crucial clinical information using their Apple devices, thus improving interoperability. On top of this, the software’s ‘MyChart’ helps users to view medical information, schedule appointments, message doctors, manage medical history via a personalized portal.

3. drChrono EMR Software

drchrono

drChrono has maintained #1 ranking for four years in a row as per a survey conducted by Black Book Rankings. The software allows medical practices to manage clinical charting, billing, patient intake, and revenue cycle management. Tried and tested by orthopedic facilities, drChrono is a reliable EMR solution that offers cloud-based services and supports multiple devices, such as smartphones and tablets. It is also Meaningful Use Stage 1 and 2 compliant.

The platform also includes customizable medical forms, scheduling tools, e-prescribing, patient portal, and real-time eligibility checks. drChrono is the first company to offer an app for the iPad and iPhone. On top of this, it comes with an App Directory that includes a medical API for healthcare app developers and offers multiple apps. It additionally provides contemporary technological solutions and services for practices of all sizes.

4. AdvancedMD EHR Software

AdvancedMD

AdvancedMD is a cloud-based electronic medical record (EMR) and practice management solution for independent physician practices and medical healthcare organizations. The software is acclaimed all over the US for its speed, secure access, and customer support. Key features include medical billing, telemedicine functionality, e-prescribing, scheduling, documentation, patient engagement tools, reputation management, business intelligence reporting, and financial analytics that work together to automate medical practice workflows.

AdvancedMD EHR automatically updates to manage regulatory changes such as Meaningful Use and ICD-10 efficiently without compromising patient care. The software’s medical billing services enable private medical practices to outsource their entire billing operations. It allows users to get their claims process managed specialized billing experts, ensuring all claims get paid accurately.

Read: All you need to know about AdvancedMD EHR & Medical Billing Software

5. PrognoCIS EMR Software

prognocis

Set up in the early 2000s, PrognoCIS is a fast and flexible provider of EHR services. The EHR vendor is suitable for practices and hospitals of all sizes. It also provides integrated modules for practice management, EHR, and patient portal application. The software offers cloud-based solutions that comply with all the US Government and CMS standards. Besides, it is Meaningful Use II certified and ICD-10 and HIPAA compliant.

The platform comes with revenue cycle management functionalities that help users streamline their financial operations. With this cloud-based solution, users don’t need to worry about infrastructure investments and other costs at the time of implementation. Key features include telemedicine, practice management, eRx, etc. PrognoCIS EHR offers a customizable and tailor-fit EHR workflow that includes specialty-specific content for hospitals and practices. Their telemedicine solution is a leading platform for orthopedic practices during the COVID-19 pandemic.

6. ChartLogic EMR Software

chartlogic

One of the first in its industry, ChartLogic, offers an ambulatory suite that comes with practice management, electronic medical record, patient portal, and e-prescribing. The software is ideal for practices of all sizes and is priced at the lower end of the EMR pricing spectrum. It designed to understand user workflow, specialty, and other preferences. ChartLogic offers electronic charting capabilities that enable orthopedics to view medical history, referral letters, patient notes, diagnosis codes on a single screen. The software is in accordance with the applicable certification criteria adopted by the Office of Health and Human Services. Besides, it is ONC-ATCB certified and HIPAA compliant.

ChartLogic PM helps users manage administrative operations, such as scheduling and registration, eligibility and verification, billings, collections, collections, reports, and user dashboards. It also integrates with ChartLogic EMR. Primary features include electronic prescribing, patient portal, revenue management technologies, custom notes templates, dashboards, and more.

Just like other ambulatory practices, orthopedics also need EHR solutions that will speed up their workflow, make it easier to produce notes for each patient, and give faster access to diagnostic imaging.

Related Reading

Working Remotely? Tips to Ensure Strong Cybersecurity on your home devices

Working remotely?

Working Remotely? Tips to Ensure Strong Cybersecurity on your home devices.

Since the COVID-19 outbreak, governments around the world were forced to shut down parts of the global economy to flatten the curve of the virus. As a result, businesses and their employees had to adjust to working remotely.

Working from home has its challenges, especially for the medical industry. One of those challenges is having secure cybersecurity. Not everyone’s home networks are safe, and without the aid of IT professionals, files & data are at significant risk.

Doctors, accountants, and any industry that deals with personal information of clients should have strong, safe networks to operate on to avoid cyber attacks. So how can you secure your home system so you can complete your tasks without the risk? Keep reading to find out how to increase your cybersecurity.

Must-Know Cybersecurity Information in 2020

Not all industries are the same. Some sectors require more cybersecurity than others. The finance and healthcare trades typically have the most prominent targets on their backs because their systems store confidential files hackers are looking for, such as:

  • Banking details
  • Home addresses
  • Social security numbers
  • Beneficiary information
  • Health care or finance information

In 2020 15% of cyber breaches involved the healthcare industry, and 10% were focused on the financial sector. These breaches occur on servers as well as unsecured networks. Additionally, healthcare had the highest cost in data breaches for $429 per medical record.

IT professionals and software developers were concerned about the increase of cyber attacks during the COVID-19 lockdown & rightfully so. If cybercriminals can hack into professional medical cloud computing platforms, they will be able to breach many home networks easily. Here are the COVID-19 related cyber-attacks to be aware of.

MalSpam and Phishing

Phishing is when you’re sent an email from what seems like a reputable company. There’s typically a link that transfers you to a website where you’ll be asked for your credentials, such as passwords and banking details.

MalSpam is known as malicious spam, which is an email that contains infected links that will redirect targets to websites that have Exploit Kits (malicious toolkits).

Cybercriminals are using the COVID-19 topic for phishing and MalSpam attempts. They send out an email that looks like it could be valuable information about the virus. But when you open the mail, it may be filled with cyber viruses, or it will ask you to donate money to their cause.

It’s essential to identify the type of emails that get sent to you and staff members to avoid opening malicious mail. Here are a few ways to identify phishing or MalSpam:

  • The email is written in poor grammar
  • Content is peculiar and implausible
  • Embedded links have odd URLs

Never click on links unless you’re sure they’re trustworthy. Furthermore, it’s advised never to type in your credentials on any sites that look unofficial.

Ransomware

Ransomware is a piece of software that infiltrates your technological infrastructure and encrypts all files & documents with a password. You’ll be required to pay a fee to unlock the files. It can be detrimental to medical and financial institutions because your business will cease if you can’t access data.

What’s more, the information on your patient and client files could potentially be stolen, which can result in lawsuits.

Ransomware can infect your systems through phishing emails or dodgy websites. It’s essential to train your staff on this matter because they can unknowingly infect your company’s entire network by opening spam emails.

Remote Desktop Protocol Targeting

Remote desktop protocol (RDP) is a secure network designed for people working outside of the office. But the RDP is susceptible to a breach when more employees are connected to it through an open network. A VPN (Virtual Private Network) can assist in hiding the RDP effectively.

Credential Stuffing

Credential stuffing is a type of cyber breach where the hacker steals lists of usernames and passwords from a server. That’s why most sites and systems have two-factor authentications as an extra precautionary measure.

These two-factor codes are typically sent to a person’s email or cellphone number, and only that person can enter the site once the code is punched in.

How to Implement Strong Cybersecurity Measures

There are several ways you can secure your digital platforms when working remotely. IT experts would advise you to have the following to secure their connections and prevent malware & cyber breaches.

Secure Business Networks

Critical Security Controls (CIS) is the recommended action for business network cyber safeguarding. These controls are used for businesses to prevent many prevalent cyber-attacks. CIS is especially crucial for home Information Technology environments. It is what CIS can do:

  • Updates anti-malware platforms regularly
  • Implements consistent auto backups
  • Protection of saved files
  • Blocks communications on unauthorized ports
  • Trains employees on the consequence of cyber attacks
Vulnerability Management

Online medical platforms must have vulnerability management (VM) from tech support. It is the practice of identifying, classifying, and prioritizing potential vulnerabilities in software. VM is crucial for network and computer security, which can minimize cyber attacks.

Secure Home Networks

All devices employees use while working remotely, must be enabled with the latest cybersecurity. Here are ways you can secure your devices while working from home during COVID-19.

Virtual Private Networks

Virtual Private Networks (VPN) are versatile because they’re used for a multitude of tasks such as streaming and private internet browsing. The purpose of a VPN is to hide your IP address and encrypt all your readable information so that it’s invisible to any unauthorized third party.

A VPN can be useful for those working in the medical industry or any sector that deals with sensitive documentation. It is because your activity can’t be seen by your ISP (Internet Service Provider). You certainly don’t want your ISP to view confidential documentation. Install a VPN to make your working activity private.  

Password Managers

Some companies have various systems that you’ll need to log into. It’s essential never to use the same password for all your online accounts. Utilize a password manager to generate lengthy codes that are difficult for cybercriminals to decipher.

Implement Two-Factor Authentications

All the online and cloud computing sites you use must have a two-factor authentication tool when logging in. As mentioned before, it’s an extra layer of protection in case a cybercriminal has access to your credentials and tries to log into your accounts. The criminal won’t be able to log into the site without the two-factor code.

Anti-Virus Software

Anti-virus software is developed to scan your device regularly to find and eliminate threats on your device. If you have a high-quality anti-virus on all your devices, it can find and eradicate infections before they can spread.

Firewalls

It’s crucial always to have your firewall activated. Think of a firewall as your device’s defense mechanism. This type of software prevents malware and viruses from entering your system through open networks or shared files. If you regularly access the internet, then you must have your firewall activated at all times.

Implement Lock-Outs

Lockouts on online systems should be implemented to prevent unauthorized access to files. So whether you’re using a health record management system or a banking app, after three tries of typing in a password incorrectly, you should be locked out.

Subsequently, you’ll have to contact IT support so you can reset your password to log back in. The reason for lockouts is to prevent someone from accessing files by trying to crack your password. If they enter the password incorrectly three times, they won’t be able to access the site without tech support.

This step may slow down workflow if you’re the one who forgot the password, but it’s a necessary security feature that should be on all devices, especially cloud computing platforms.

Anti-Spyware

Spyware is when the software is installed on your device to monitor your messages, calls, and online activity. It can be detrimental for remote employees not only on a business level but a personal one too. Ensure you have strong anti-spyware on your device to find and eradicate malicious programs on your device.

Regular Updates on Routers, Computers, and Software

Ensure that you have gone through all the settings on the cybersecurity platforms you’re using. You must enable regular updates and backups on your systems so that your devices are secure at all times. Make sure you get regular reports on scans so that you can manage your devices.

Final Thoughts

To sum up, cybersecurity is a necessity now more than ever before, so ensure you have excellent digital defenses.

When working with confidential online files at home, it’s crucial to secure all aspects of your devices such as USB ports, printers, storage, and cameras.

By installing all the cybersecurity software and regularly inspecting your devices, you can minimize the chances of getting attacked by hackers. You don’t have the inspection and maintenance expertise of your IT department on your home network, so it’s up to you to secure your systems.

If you’re unsure which cybersecurity platforms to use, talk to an expert. It’s worth the effort!

Infographic - Cybersecurity Tips for Remote Healthcare Workers

How Much Will It Cost to implement a Top EMR in 2021?

cost to implement an EMR

In uncertain times of COVID-19, technology has become an enabler for many businesses and industries across the world. Healthcare is no exception. EHR & telehealth software, though a bane of many healthcare organizations, has provided the needed connectivity and flexibility required to deliver care in these difficult times. By enabling providers to offer telehealth services and improve processes at the point of care in emergency departments, EHR companies have stepped up in these times of crisis.

While many physician practices see the utility of either switching from paper or out-dated EMR systems to a solution offered by top EHR companies, cost considerations can be a hindrance.

In this article, we will explore whether the investment is worth the cost involved in implementing EHR software in 2021.

We’ll cover:

Justifying the cost of implementing a Top EMR

A significant obstacle faced by healthcare organizations during EHR selection is whether the investment is justifiable, especially if it’s a new practice with low patient volume or one that has already spent a significant amount of time and money with the wrong EHR company.

While listing the pros of investing in a top EHR company, organizations must look beyond meeting regulatory requirements towards the tangible benefits an EMR provides.

Here are some key benefits

  • Easier access to patient information
  • Fewer documentation errors through charting and recording
  • Improved quality of provided health care
  • Secure and protected storage of patient records
  • Maintained patient privacy
  • Streamlined daily operations

How Much Will EMR by top EHR Companies Cost?

While there are clear benefits for implementing an EMR, an approximation for the return on investment can only be determined if we know the cost involved.  For the purchase to make sense, the price should not succeed the profits in the long term.

The cost of implementing an EMR system can range from anywhere between a hundred to thousands of dollars.  Here are a few scenarios:

  • If you so choose, you have the option of using a low cost or even free EMR. Most low-cost EMRs cost between $80 to $100 per provider per month. These EMR software companies, however, do not provide any customization or training to their users.
  • If, however, you decide to pay and opt for a traditional on-premise EMR solution, you should expect to spend between $1,500 and $5,000 on Software licensing. If you consider hardware installation and employee training costs, it will end up costing a small practice around $10,000.
  • The price for cloud/web-based EMRs will be lower than on-premise EMR solutions.
  • Enterprise-level systems usually implemented in hospitals, such as Cerner EMR and Epic EMR can cost.

The following chart provides an estimated average upfront cost, yearly cost, and five-year total cost of ownership (TCO) for on-site and SaaS EHR deployment based on the experiences of Regional Extension Centers (RECs).

estimated average cost for EHR software 2020

In addition to deployment types and organization size, several other aspects determine the overall cost of EMR software you will incur.

These include:

  • The pricing model
  • Training & hardware cost
  • Update & customization costs

What Main Factors affect EMR Cost?

Pricing Models

As you may already know, different vendors use different pricing models to price their EMR software. You must choose emr software companies whose pricing model fits your practice financial situation. Here is what to expect from different vendors.

Subscription Pricing

Most vendors offer a fixed monthly per provider pricing, commonly referred to as the” pay-as-you-go” model.

Medical practices have to pay a one-time upfront cost that usually ranges between $1500 to $5000 for a small practice, followed by a monthly fee that can be anywhere between $200- $700 per month per provider. Though these vendors do not charge separately for users such as the front desk or your billing staff, they will consider staff that bills under their NPI as a provider, thus liable to pay the monthly fee.

The cost of part-time providers is also different and usually lower than that of a full-time provider. In some cases, this pricing model is paired with a “percentage of collection” pricing with a Free EMR if you use the company’s medical billing services.

Examples of Top EHR companies with this model:
Pay per visit Based Pricing

It is a relatively less popular pricing model offered by either small players in the EMR market or by bigger  EMR players specifically to practices with low patient volume.

You only have to pay based on the number of patient encounters or, in short, the usage of the system rather than a fixed monthly cost. The cost per visit can range from anywhere between $.50 to $1.5 per visit. It will cover the maintenance, support, and usage cost.

Examples of EHR companies with this model:
EMR Deployment Types
On-Premise

Purchasing EHR software on-premise allows you to host it on your servers. You’ll need a perpetual software license, which is usually accompanied by a high upfront fee ranging from between $1,200 and $500,000 or more. The provision also needs to be made for initial purchasing of hardware such as servers and ongoing premium support, for example, expanded telephone support hours.

Hidden costs to note with an on-premise purchase include software customization, integration with your current online systems, and payment of IT staff for additional maintenance work.

Opting for an on-premise server model means the management of operating the EHR software and related technology rests on you. Your practice will need heavy-duty servers, a reliable data backup storage system, and perhaps even additional technologies to do so effectively.

Cloud-Based

It is usually the cheaper option. Buying EHR software via a cloud-based deployment means your data will be stored remotely on your vendor’s servers, allowing you access through the internet. It requires an annual or monthly subscription license. A monthly subscription fee is generally charged per provider or user. It can be from as little as $200 to as much as $35,000. The latter is what more major healthcare organizations can expect to pay, in addition to premium support such as extended phone support hours.

The initial start-up fee of a cloud-based EHR system isn’t as high compared to the on-premise price. The benefit is there aren’t as many upfront costs as an on-premise system. You also won’t need to include the purchasing of additional servers, data security, storage, and backups in your budget. Much like the on-premise option, you’ll need to budget for the hidden costs of software customization and integration with your current online systems, as well as additional storage for patient data.

A drawback to using a cloud-based EHR system is how it limits your staff’s access to the software. If you have a small practice, this works exceptionally well. Should more users be required to access this software, your monthly fee will increase.

Installation Cost

Remember, whether you opt for on-premise or cloud-based deployment, you’ll still need to invest in your local network hardware. Consider desktop computers, iPads or tablets, printers, scanners, and other devices you might require.

You’ll be using the expertise of qualified technicians to install such systems, and this does directly influence the software’s cost. On average, you’ll spend between $1,000 and $3,000 on installing and configuring software.  The financial provision also needs to be made for the required technical support.

Staff Training Cost

The majority of medical practices can spend at least $20,000 on EMR software staff training costs. Your staff needs to know how the systems work, regardless of whether you’re using entirely new software or merely migrating from one system to another.

Sometimes this training is provided by the vendor, or it could be facilitated by in house staff. It depends on how complex the new system is. Some medical practices try to save on costs by accessing training materials online at no charge via attending webinars or tutorial videos. On the other hand, some medical practices have spent even more on training their staff.

Training offered by an expert has guaranteed that their employees understand the new EMR software well enough to use it successfully and has significantly reduced time spent on training, so productivity isn’t primarily affected.

Maintenance Cost

Within your first year of implementing EHR software, you could anticipate spending on maintenance costs to total at least $85,000. Remember that as smart as technology is, it can also malfunction. Even a top EMR system can be affected, so ongoing system maintenance and technical support are required to ensure it’s working as smoothly as possible.

Sometimes the continuous maintenance and upgrade costs are included in an organization’s EHR software monthly subscription.

Customization Cost

As mentioned above, customization of software involves, for example, creating patient note templates with customized fields as well as being able to report or analyze patient data.

Even purchasing a standard EMR system involves a few amendments and adjustments to meet your practice’s needs better. If you opt for a top EMR software system, you can expect to pay for it. You might be able to save on some of these costs should you opt for a system with a high level of user configuration.

Customization cost depends on your selected software features and how many users will be accessing it. It’s important again to remember how on-premise or cloud-based hosting influence your costs.

Data Migration Cost

If you have existing software that you’d like to extract, export, and import onto the new system, you may have to incur an additional cost. Some vendors offer essential data migration free of cost, while others require additional payment based on the volume and size of the extractions.

Is It Worth It?

The various advantages of using EHR software are evident. There aren’t only financial benefits from such a system, but also practical paybacks.

According to a study conducted by Health Affairs, an average practice of multiple physicians can expect to spend approximately $162,000 on EHR implementation. Furthermore, medical practices should cover their initial installation costs within roughly two and a half years. After that, they can expect to receive an estimated average of $23,000 in net benefits for each full-time staff member annually.

Taking into consideration these findings, medical practices in various settings, sizes, and financial conditions can find some justification in utilizing this software. It’s more than merely complying with regulations; it’s enjoying the benefits.

Medical practices have reported increased efficiency as their main motivation for utilizing EMR systems, in addition to improved service delivery, overall reduced costs, and increased profits.

Ensure that investing in EHR aligns with your current short term budget, and include a cost-benefit analysis and ROI forecast before going ahead with your final selection.

Opting for an EHR software in 2021 does involve initial and ongoing investment. With the numerous long term benefits, your medical practices’ budget should also include implementing an EHR system in 2021.

EHR Implementation Roadmap and Costs

EHR Implementation

The adoption of an Electronic Health Record (EHR) system is a multi-step procedure. To plan a successful system transition, a medical practice must prepare strategically. On average, it takes approximately 8 to 12 months to successfully implement a new EHR software, but the transition time entirely depends upon the strategic planning. A good plan can certainly save hours of work and effort for every member on your team.

Here’s a comprehensive guide to facilitate successful EHR implementation in a medical practice using some simple steps.

1. Build an EHR Implementation Roadmap

The first step in implementing an EHR system is to outline the major tasks and procedures that need effective execution by your team members including IT staff, physicians, practice managers, nurses, medical assistants, etc. The key tasks will be:

  • Enlist your implementation team from stakeholder groups
  • Outline your costs and define the total budget for implementation
  • Check your software for HIPAA Compliance
  • Transfer of patient and practice data from record systems
  • Develop a training program for users
  • Decide on what to do when your EHR system is down
  • Define and state your go-live tasks
  • Point out critical success aspects and evaluation strategies

2. Build your Electronic Health Record Implementation Team

After defining your implementation tasks, you need to recruit people to perform each task according to your schedule and budget. A strategic team will help drive your implementation process smoothly. The team will include members including administrative staff, physicians, medical assistants, and nurses. Each team member will add to the implementation process by passing on their EHR skills and identifying implementation challenges along the way.
The following team members can be sourced to run the implementation process effectively:

  • Project Manager – responsible for managing the implementation team
  • Application Developer – responsible for customization of a system
  • QA Test Engineer – responsible for the performance and system testing
  • Application Analyst – responsible for data transferring
  • Nurse Advocate – representative of nurses
  • Physician Advocate – representative of physicians and advice on training
  • Billing Advocate – representative of the billing department and advise on data and testing
  • Meaningful-Use Manager – needed if MU attestation is required
  • Super-Users – the initial adopters for training programs

3. Define your Budget and Predict EHR Implementation Costs

Following elements are mandatory to consider when defining a budget for an EHR implementation:

  • Practice staff and temporary staff
  • Productivity loss (often estimated as high as 50% reductions)
  • Hardware and network upgrades
  • Customization service from the EHR vendor
  • Other Consultancy costs
  • Vendor training expenses
  • Data backups and storage along with cloud EHR costs

According to a recent EHR report, most medical practices spend about $6,200 per user of their EHR software. Healthcare practices can keep this figure in their mind when deciding on their EHR implementation budget.

4. Analyze your Software

After you are done with defining your budget, make sure your software is HIPAA Compliant. Your healthcare organization may also need to get through a HIPAA risk assessment. Your health IT vendor can help you identify if your software is compliant.

5. Transfer Patient Data

Now comes the step of transferring patient and practice data. For this, you need to sort out the ways for migrating your data from your record systems to the new EHR. You can perform this task in a variety of ways such as assigning this task to the existing staff or hiring additional staff to upload information into the new EHR system.
Key aspects of EHR data migration include:

  • Converting the paper records into electronic records
  • EHR database setup
  • Data management and verification
  • Mapping legacy data to new databases
  • Migrating information to the new system
  • Testing new data inputs
  • Testing and verification of legacy data

6. Develop a Sustainable User Training Program

Now that you are done with transferring data, deigning an interactive training program for users can have a significant impact on the final ROI of your system.
Good training programs offer:

  • Program advocates
  • Coherent communication channels
  • Vendor support teams
  • Role-based training for proper relevancy
  • Stable feedback options to keep users connected with project management

7. Be Prepared when your EHR system is down

We cannot dismiss the probability of inaccuracies when technology is involved, so medical practices must be prepared to tackle occasional glitches. A solid backup plan can help you solve potential problems.

Some of the instances include power shut down, system-wide malfunction, etc. To deal with such issues, you will require strategic procedures that assist physicians and staff to manage the regular tasks when the EHR is unavailable.

Considering the following aspects to create strategic procedures:

  • How to notify staff and physicians in the case of downtime?
  • How to keep the patient-care flow from being disrupted?
  • How to ensure patient check-in despite the downtime?
  • How to assist physicians and staff document the visit?

In addition to the electronic procedures, availability of paper procedures can help to tackle the EHR downtime.

8. Define your “go-live” tasks

The next step in your EHR implementation process is pointing out the necessary activities around your go-live day. This includes:

  • Pre and Post system testing process
  • Comprehensive communication guidelines for patients (also includes the expected downtime)
  • Recruitment or scheduling of overtime or temporary staff
  • System reporting procedure and project evaluation
  • Alteration of appointments and schedules
  • Network speed and reliability analysis
  • Effective communications on noticeboards etc.
  • Data Backup and Recovery
9. Evaluate Critical Success Factors

Once you have surpassed the go-live stage, evaluate the critical success factors for your EHR implementation. But how can you do that?
You can evaluate your EHR implementation in numerous ways but the most suitable one for your practice relies on your practice goals:You can evaluate your EHR implementation in numerous ways but the most suitable one for your practice relies on your practice goals:

  • Calculate your organization’s ROI to determine profitability
  • Asses patient satisfaction rate through a survey to check the quality of care
  • Keep a record of patient throughput to find out the efficiency
  • Find out the physician satisfaction rate to evaluate user training
  • Determine the data error rates to asses quality

If you are looking to implement your EHR in the best possible way, then this comprehensive guide will facilitate your process like no other!

Difference between EMR and EHR

EMR vs. EHR

The healthcare industry has been steadily transitioning from the traditional cumbersome paperwork to digital record keeping in the modern era. The implication of technology across various fields throughout the globe has made it possible for us to do what was once considered heavy tasks, with the utmost ease. Patient record keeping was considered a tough task with several dire liabilities. Hospitals and clinics were facing a hard time looping through the records to search for the data and history of a particular patient. However, today, the EMR and EHR software has made it easy for healthcare professionals.

What is EMR?

EMR refers to the Electronic Medical Record which can be comprehensively seen as a digital version of all the paperwork that one finds in a clinician’s office. It efficiently keeps track of the patient’s medical history and treatment details.

EMR is a software that is designed to help healthcare practitioners access the medical history of their patients. One can easily identify the problems with the patient in the past and the treatment given to them, details about the individuals who are due for checkups, and information regarding the dosage and vaccination.

It is very helpful in monitoring a patient and improving the overall quality of care. However, the problem occurs with electronic medical record software when one has to transfer the data. You cannot share it easily with other consultants. The only way to share data in an EMR is through mail or print.

What is an EHR?

EHR refers to Electronic Health Record that can be perceived as an advanced version of EMR. It offers a wider range of features and functions to utilize and improve medical practices. It is extremely useful and efficient in taking the patient’s data and analyzing it in a broader spectrum.

You will find that sharing data is very easy with the electronic health record software. It is designed in a way that a team of medical specialists can collaborate and work together to help a patient return to good health. Some people consider it as a central database that records the data from all the clinicians and keep it at one place, making it accessible for other providers as well.

What are the features of EMR and EHR?

When we analyze the features of electronic record-keeping software for clinicians, we find that EHRs offer everything that an EMR can offer. But there are features in an EHR that you won’t find in the EMRs.

For instance, an EMR allows a person to create a record of a patient. Once you assign the unique id to an individual, you can update and add more medical data. It permits you to update the medical history of a person, adding details regarding each checkup and medication. Moreover, you have a chance to view the history of a person and see the vaccinations and medications given and for what purpose they were given.

But on the other hand, we have EHRs that offer a wider range of operations. Just like an EMR, you can create, update, and check the medical record of a person. However, you can also add lab data and imaging data that include blood test reports, CT scans, ultrasounds, X-ray imaging, etc. Along with it, the demographic data gives you an option of analyzing the patient’s medical history in a better way.

Ultimately, EHRs give you a chance for interoperability which is not present in EMRs. But that does not suggest by any means that EHRs are always a better choice than EMRs. It depends on what you need.

What is the difference between EMR and EHR?

EMR and EHR are two types of software that we use for record-keeping purposes in clinics and medical facilities. When we discuss EMR vs EHR, it is mainly regarding the differences between the two. Stating briefly, EMR provides a short overview of the medical history of a patient whereas EHR gives you an option to store data in a broader spectrum and perform in-depth analysis on it.

Most of the time, clinicians use EMR to diagnose and treat patients and keep the relevant record. You cannot share the information outside of the individual practice, which makes it hard to consider the opinion of other experts.

However, the EHR gives you an option of sharing the information of a patient with other authorized staff. You can keep all the data, including the reports, tests, and other records at one place and make it accessible for other medical experts without any trouble.

EHR vs. EMR: Which one to choose?

When you hear Electronic Health Record Software and Electronic Medical Record Software, it is hard to distinguish between the two. Despite looking at the features, some clinicians and hospitals find it hard to select the right system for their practice.

The choice of a record-keeping system is one of the biggest and toughest decisions for any healthcare organization. Whether it is a hospital, a clinic, or any other place, you need to consider your requirements and system in place when making the selection.

Start by considering whether you need a centralized system for all doctors or dedicated software for each practitioner. If you want to keep things together at one place and assure that the record of a patient is accessible by any doctor in the facility, you can go for the EHR. However, if you are looking for a dedicated system that only keeps information regarding the diagnosis and treatment of a patient, you may like to acquire EMR.

Why must you move on to electronic records?

Considering the EMR vs. EHR, it is all about moving to an electronic record system and bidding farewell to the paper records. In today’s digitized age, it has become a necessity. The electronic records are fast and secure, providing you an opportunity to update the information and access it in no time. It also eliminates the chances of duplication, and you’ll have to spend less time and money in maintaining the records of your patients.

But before you choose any software, make sure that you consider your needs and select the one that addresses your requirements appropriately for a smoother, more successful medical practice.

Barriers to EHR interoperability and their solution

Barriers to EHR interoperability and their solution

With the advancement in Information Technology, many software have been developed to save and manage useful information. EHR (Electronic Health Record) is the digital system to manage and save the information of a patient’s paper chart. It holds the patient’s medical history, diagnosis, medication and some other information related to health. It helps patients to get the advice of doctors anywhere from the world for better treatment. But some barriers are limiting the use of EHR between health care centers.

Office of the National Coordinator for Health Information Technology published a report in 2018 which calls the six challenges for instigating EHR.

Technical Barriers

One of the biggest barriers to EHR interoperability is technical issues. Due to technical issues hospitals are unable to receive or send the data. Sometimes it becomes difficult to send or receive the data if the exchange partner doesn’t have EHR. Data quality and data matching is another major technical issue.

Financial Barriers

It can cost a lot for health system provider to develop an EHR system. The developing, optimizing and maintaining the patient record electronically can be expensive for the organizations who see fewer business incentives in it.

Trust Barriers

Each patient’s data and health record has been taken as an asset for health centers. Most centers take it as leakage of privacy as they consider each individual’s data as an advantage due to the competitive environment. Lack of trust between hospitals limiting the use of EHR and exterminates the real purpose of an electronic system.

Administrative Barriers

As EHR saves every record of the patient including administrative information like billing information and federal requirements. It burdens the EHR system and makes it difficult to move from one place to another electronically.

Reporting Requirements Barriers

There are many set standards associated with electronic health record which are not useful in sharing. These requirements only create problems the data transfer. Quality measures report which is not relevant but necessary to add for federal report requirement.

IT usability

EHR can be difficult for end-users due to its interface which varies organization to organization or system to system. Lack of developer engagement with end-users also create problems and make it difficult to implement. Less IT skills is another barrier to using EHR.

Other Common Barriers to EHR Interoperability

There are also other challenges to EHR implementation. Staff resistance is one of them. Staff finds difficult to accept the changes8 in the working environment. When an organization implements EHR and change its patient data keeping way staff shows a lack of interest and low work efficiency has been noticed in most of the cases. Data migration seems very tiring, but it needs to get migrated very accurately because the patient’s data is a very sensitive document.

Biggest problem with EHR in 2018

In 2018 Medical Economics asked over 3,000 physicians about their greatest challenges when it comes to operating their EHR systems
These were their answers.

What have been the disadvantages of your EHR system (if any) to your practice's daily operations?
Barriers to EHR interoperability and their solution

Solutions to EHR interoperability

  • Adoptability of EHR remains a struggle for hospitals due to obstacles in the implementation. But there are a few solutions which can make it easy to adopt.
  • There should be a good network available in the health center to send and receive the data from patients. Due to non-necessary administrative details which makes data heavy, while good internet speed can make it easier to transfer the data.
  • More device accessibility should be easy so doctors can access the data at any place where they want it. The health centers should not expect from the doctors that they will go to the place where a laptop or system will be available with EHR availability.
  • It is very difficult to enter the data from the patient’s manual charts to an EHR system. So the organization should make it easier for the staff to enter the data. The process can be done slow. The patient’s charts need to be prioritized to determine how far back data should be saved in EHR. The data entries should be saved from recent to past orders.
  • Health Centers should extra pay their staff to overcome the resistance while implementing an Electronic Health Record system. Because when saving the data and adopting the new system staff needs to give overtime to the organization.
  • All staff should be given proper training of IT usability before implementing the EHR system. Staff and EHR users often find difficulties when they have less information on technology uses and implementations.
  • Every hospital or health care center has its workflow and system. A specific type of EHR system can’t be implemented everywhere. So it is very necessary to work on customizable EHR system. So health care centers should be in contact with vendors of an EHR system.
  • One of the biggest barriers in EHR implementation is typing. Physicians find it’s very difficult to type while finding the required data and it disturbs their workflow. Nowadays, speech recognition software are very common. By installing such software the use of EHR can be made more beneficial. The other problem with continuous typing is that physicians lost their eye contact with the patients. With the help of third-party speech recognition software, the problem can be solved.
  • EHR systems should be able to track referrals, consultations, and all other necessary records so physicians can easily follow the patient progress during treatment.
  • Data lock and secrecy should be avoided for full interoperability of EHR system. Data should be open so it can be exported and exchanged to other health centers easily.
  • Patients should be engaged with the EHR system easily. It should be easy to use on mobile and their laptops without any hurdle.
  • The most important point is that EHR systems should be used which are certified. It should give users an option to automatically collect the feedback to improve the system performance.

This guide can help users minimize the major barriers to EHR interoperability and take the most out of their EHR implementation.

Cerner EHR vs Epic EHR Comparison

Leading EHR software companies

Are you struggling to find an EHR solution for your healthcare organization? Evaluating and selecting the right EHR solution for your medical facility can be confusing and troublesome. Choosing the wrong EHR system for your hospital can confront you with extreme challenges. A good deal of research is required to pick the most suitable EHR solution for you to best suit your medical practice. While the services provided by most healthcare IT vendors are more or less the same, there are some points of comparison that demand thorough consideration.

To save you time and hassle, we present you with a comprehensive comparison between the two biggest EHR solutions Cerner EHR vs Epic EHR:

Difference between Cerner and Epic

Both EHR substantial solutions offer their own unique sets of functionalities. Cerner caters to small practices and owns a percentage of the market share of hospitals with almost 10-25 beds. Whereas, Epic caters to large hospitals, but is also struggling to attract small medical practices. Let’s dig deep into how these EHRs differ from each other.

Interoperability

A good EHR system must be able to integrate with other systems and software in order to exchange and make use of information.

Cerner

Cerner EHR has built-in interoperability capabilities to help users exchange information across healthcare IT systems.

Cerner has three platforms to make integration possible with external systems. This makes connecting with operational, financial and clinical data easier. The EHR solution is now struggling to make application program interfaces that will increase integration with third-party vendors for better healthcare services.

Cerner offers a longitudinal patient record that enables clients to access a sorted out, organized perspective on numerous sources of clinical information to ensure better patient care. In addition to that, Cerner has set “interoperability” as its core initiative as it is a founding member of the CommonWell Health Alliance, a non-profit and independent organization working towards the development and deploying of interoperability solutions.

Interoperability Ticker is another feature available on the Cerner website that helps in keeping a track of pharmacy and clinical transactions along with health data exchange. For years, Cerner has improved towards initiatives that help industry get to a common language that promotes a free and secure exchange of health data.

Epic

Epic EHR has received criticism for lack of integrations as it offers less interoperability compared with its competitors. Epic has been avoiding to join marketplace collaborations that claim to work towards interoperability, such as the CommonWell Health Alliance. Although the EHR provider is making efforts to improve in this regard.

However, connecting Epic to other such software is easier via Direct protocol, which means its robust connectivity to other EHRs makes it better than Cerner. Epic additionally offers a Happy Together feature. This unique feature enables healthcare providers and patients to access data with multiple sources in a centralized, merged portal view. It further assists healthcare organizations to take actions such as searching information across the health systems, duplicate lab order checking, direct messaging, scheduling, recovering reference-quality images while working as a single unit.

Implementation and Installation

Installing and implementing an electronic health record (EHR) system can be arduous. So, it’s important to consider the time, cost, and effort involved in installing and implementing a new EHR.

Cerner

Cerner does not enjoy a great reputation when it comes to a smooth and successful implementation. While, for the installation, users are provided with a handy task list that makes it easier to execute everything they require with the chart available on the list. This will certainly not let you miss out on documenting anything. But so far, Cerner has not announced any big changes regarding its implementation or installation.

Epic

Just like Cerner, Epic does not have a good record when it comes to under-budget implementation. Although the installation part costs users millions of dollars and they often end up spending more than what they expected. The need to hire IT staff for installing Epic is a big concern as it increases the expenditure involved. But at the same time, it is easier to navigate through.

User Interface

The improved user interface has a direct relation with increased EHR use. 47% percent of healthcare executives have made it their top-most preference when deciding what to look for in an EHR.

Cerner

A report from KLAS has given Cerner an upper hand over other EHRs in terms of usability as per the views of clinicians, care managers, and program administrators.

However, reviewers have found its UI to be not as intuitive as expected. According to a reviewer, the interface is difficult to navigate, which makes it difficult to focus on patient care. The system is poorly designed and unintuitive.

Epic

Epic has received a mixed sort of reviews for its UI. Some reviewers praise it for being easy to use and quick to implement. They go on to say it is easier for users to navigate between documents and notes. While many are critical of Epic’s UI and complain about the time it takes to learn the system.

What we have learned from the overall reviews is that, once you have learned its UI, everything is fairly streamlined.

Customer Support

Unhindered customer support is what makes an EHR software appealing.

Cerner

Cerner offers live support 24/7. The support team is available to guide all the time, and the staff is very helpful.

Epic

Epic provides excellent technical support. But Cerner gets the competitive edge since the service provider works with the user as a partner.

Which One to Choose? Cerner EHR vs Epic EHR - Comparison

This entirely depends on your budget and practice size. If you are financially restricted and looking for an EHR to serve smaller hospitals or private practices, you should go for Cerner. But for larger hospitals and well-off buyers, Epic is quite suitable. (Related: Top Alternatives to Epic EHR)

In a nutshell: if you are looking for greater interoperability and more integrations, better population health management functionality, and need access to support 24/7, then Cerner is a better option for you.

Epic is the right option if you are after a pleasing UI, which is really important to automate your daily tasks.

Cerner EHR vs Epic EHR Comparison

We hope this comprehensive guide on Cerner EHR vs Epic EHR – Comparison will offer helpful insight to those looking to make a well-informed decision between Epic and Cerner.

Medical Billing Software vs. Practice Management Software

Comparison of Medical Billing Rates

With a plethora of different innovative and seemingly attractive health IT software available on the market with their big claims and promises to be worth your money, it can be exceedingly confusing and overwhelming to identify which tools you actually need and which might just be an impulse splurge on your account (we don’t blame you, sometimes even thoughtful choices can end in unmitigated disaster). Besides, when it comes to healthcare, there are far bigger ramifications of getting the wrong software than just wastage of money and resources. With medical healthcare IT platforms, there is still confusion around the commonly used services such as the difference between EMR and EHR software or between Practice Management and Medical Billing Software.

Every healthcare practice has its own set of unique needs and challenges. While some providers seek more efficiency in patient registration, others want streamlined processes of sending claims to insurance companies. Moreover, a number of healthcare providers prefer using the latest technology to notify patients of upcoming appointments, lab reports and billing details more promptly and accurately. Whereas, others may be looking for some combination of these upgrades, or all of them.

In this article, we intend to explore the unique benefits and defining differences between Medical Billing software and Practice Management in order to draw a comparison to help you decide which one is better for your medical practice.

What does Medical Billing Software do?

A Medical Billing Software essentially automates tedious and repetitive day-to-day billing tasks to eliminate manual effort and any possibility of error. More tasks accomplished by the software include a submitting, following up on, and appealing claims with health insurance companies in order to receive payment for services rendered; such as testing, treatments, and procedures. There are dozens upon dozens of computerized medical billing systems on the market today, that range in their functionality and features, from simple electronic billing to highly sophisticated automation tools. The most basic medical billing services help providers print out statements based on demographics and billing codes input by the user. The more advanced medical billing software enable providers to scrub and process claims electronically, post payments, generate advanced reports and much more.

Why you should have a Medical Billing Software?

What might be the biggest, long overdue benefit of having a Medical Billing system is ridding yourself of those long trails of paperwork. Goes without saying that keeping track of patients’ records, billing history and claims electronically is far easier, efficient and secure than paperwork. This will subsequently also reduce the cost of hiring additional employees, paying a portion of their social security and insurance costs, space and time used in the office managing the paperwork, etc. Here are some more major reasons why purchasing a medical billing software is a great idea:

Automation and all the time you’ll save with it

Most precious of all the currencies, having to generate billing statements, process, scrub and submit claims manually, that too several times a day, can be an arduous task. Knowing that, having automated invoicing and claims processing would be no less than divine intervention for any healthcare provider, especially when there are more dire matters at hand that need attending.

No more minute errors with daunting chains of consequences

As long as there’s humans involved, you can never rule out the chance of human errors, no matter how careful one is. Especially when it comes to entering copious amounts of data (predominantly numbers) into the system is prone to errors. A medical billing software is designed to deal with them and it helps to reduce this error by “catching” common mistakes. You can also personalize the software to your specific billing needs and further reduce entry errors by pre-programming the system. This, in turn, will save you time and money for the long haul.

Quick and easy access to patient data

Another advantage of electronic medical software is you can access your patients’ information from anywhere. Several practices and all information in one central location can be accessed via the Web. You and your employees will be able to update billing information from any office location.

What does Practice Management software do?

Practice Management software (PM) are designed to streamline the administrative workflow of a medical practice. PM enables users to organize appointments electronically, schedule daily, weekly and monthly tasks, set up meeting reminders and much more that helps reduce the workload of your administrative staff so that more pressing tasks can be attended promptly.

Practice Management is also concerned with collecting and reusing data. All patient data including patient name, demographics, insurance coverage details, and contact information is logged and secured. For new patients, all the staff has to do is enter patient data in the patient information form in the PM once and then they’ll be able to access it for use in the upcoming visits and so on. This saves your practice from wasting time filling a ton of paperwork.

The software offers features like data analysis and report creation that offer comprehensive and user-friendly reports for you to analyze the overall performance of your practice, including access to financial details on a daily, weekly or monthly basis. This helps providers have a holistic view of the flow of finances and avoid any loop-holes for a better.

Why you should have a Practice Management software?

Practice Management Systems offer a dynamic solution allowing providers to coordinate all organizational tasks and processes through improved workflows, added efficiencies and a myriad of other benefits.

Advanced Automation with higher Productivity, Profitability and Efficiency

PM software better leverages staff time by automating standard tasks. Most Practice Management software have tools for sending patients automated appointment reminders and keeping sufficient supply inventories, triggered by set parameters to automatically re-order whenever the inventory is low.

Guarantees Better Quality of Care

PM enables providers to focus on the provision of timely and quality care when it takes out hours of computation and data logging by streamlining and automating daily repetitive processes and administrative tasks. When providers do not have to worry about documentation, scheduling or various other considerations, they are able to devote their energy towards the topmost priority – the patient. This, in turn, yields better outcomes.

Get paid faster with Enhanced Billing Processes

Most PMs offer advanced medical billing capabilities that streamline payment processes and facilitate faster reimbursement. They’re designed to verify insurance eligibility early in the process when the patient’s appointment is scheduled, in order to increase efficiency. By allowing billers critical access to patient records and reports, PM allows them to effectively answer questions and fill in critical gaps in claims information. This helps in expediting the reimbursement process by minimizing chances of claim refusals or revisions between practices and billing entities that can often result in costly delays.

These software have varieties that can also produce and send electronic bills with e-commerce component that allows practices to collect payments online.

Practice Management vs. Medical Billing

Choosing between medical practice management software and medical billing software can be challenging. Here is a brief overview of the capabilities of each.

Medical Billing Software vs. Practice Management Software

Our Verdict

Both these solutions offer a range of features, functionalities and prices. For instance, If you want web-based software for an orthopedic specialty, you’ll likely be able to find a variety systems that meet your needs. But chances are, one of them will work better for your unique requirements than another. It is, after all, a matter of what your practice requires. Whether your needs are simple or requiring complex solutions with powerful tools. Billing software provide functions ranging from simple statement generators to automating all billing processes and managing revenue cycle, including billing and coding, as well as sending claims to insurance companies. On the other hand, Practice Management opens the door to multiple other convenient tools in addition to handling basic billing processes including appointment scheduling, patient data recording, storing health records and creating reports, as well as advanced automation of daily tasks. Which solution you pick will have a remarkable impact on your practice. What kind of impact it will be – You get to decide that by making a conscious and informed choice. (Related: Medical Billing Service Guide

MACRA and MIPS – Most Asked Question about EHR Certification

MACRA & MIPS

MACRA: An Overview

MACRA is the Medicare Access and CHIP Reauthorization Act. It was signed by President Obama into the law on April 26, 2015. MACRA revokes the previously used Medicare reimbursement formula with a new pay-for-performance program that prioritizes accountability, value, and quality. It provides a more sustainable payment framework for both providers and physicians. According to the Medicare and Medicaid Services (CMS), MACRA implements a new payment system that gives rewards to healthcare providers for giving better care instead of more service.

A Quality Payment Program (QPP) that implements MACRA, establishes two tracks for physicians:

  • The Merit-based Incentive Payment System (MIPS) to measure physician’s performance
  • Advanced Alternative Payment Models (APMs) so they earn revenues from alternative pay models

MIPS: An Overview

MIPS is an acronym for the Merit-Based Incentive Payment System. It is among the two payment models in the Quality Payment Program that determines Medicare payment adjustments. The program aims to ensure better patient care while reducing the costs of care and is implemented by measuring the composite performance score of eligible professionals (EPs). EPs may receive a payment bonus, a payment penalty, no payment adjustment depending on their performance.

The Composite Performance Score depends on the following measurement criteria:

  • Quality
  • Clinical practice improvement activities
  • Resource use
  • Meaningful utilization of certified electronic health records (EHR) systems

MACRA Frequently Asked Questions

This article presents some thoroughly researched frequently asked questions regarding MACRA from MACRA certified healthcare professionals.

What is the Quality Payment Program?

The Quality Payment Program enacts the key provisions of MACRA. It introduces new approaches to compensate physicians who provide healthcare services for Medicare Part B beneficiaries. The program replaces the previously used fee-for-service model to value-based care. The QPP creates two payment paths for physicians: Advanced APMs (AAPM) and Merit-based Incentive Payment System (MIPS).

Who Participates in the QPP?

To participate in the QPP, the qualifying criteria are:

  • Bill Medicare for more than $30,000 in Part B and allowed charges for a year
  • Offer healthcare services to more than 100 Medicare patients a year
  • Are Advanced Alternative Payment Models (APM)
Who is impacted by the Quality Payment Program?

The clinicians who bill Medicare Part B will be influenced by this Quality Payment Program. However, CMS is also inviting commercial payers to be a part of the MIPS model in upcoming years.

How to prepare yourself for MACRA?

To prepare for MACRA in 2019, health systems and physicians have to determine the right strategies. Following are a few steps that can health systems on how to prepare for MACRA:

  • Outline a strategy to prepare for MACRA by Q4 2016.
  • Actively attend society meetings and take advantage of the insights they offer. Renowned physician groups including American of Family Physicians (AAFP) and American Medical Association (AMA) offer their services to train and guide physicians on MACRA. In addition to that, the American Hospital Association (AHA) also offers online services such as a webinar to help healthcare systems prepare for MACRA.
  • Enlighten providers and have detailed discussions regarding new regulation.
  • Get help from the health system thought leaders to discuss ACOs, etc.
  • Evaluate your CMS Quality Resource and Use Report (QRUR).
  • In case you did not report for meaningful use then asses the penalties for MACRA
  • Review your quality measure and spot your top-performing areas.
  • Take assistance from MACRA certified healthcare professionals
Are there any Exemptions for eligible providers?

There are many exemptions for eligible providers including:

  • being in the first year of Medicare for 2017
  • participation in Advanced APM
  • seeing less than 100 Medicare patients each year
  • bill $30,000 or less in Medicare

MIPS Frequently Asked Questions

Here are a few thoroughly researched frequently asked questions about MIPS.

What is MIPS Composite Performance Score?

This score is the aggregate of an eligible professional’s scores in the performance criteria categories including quality, cost, advancing care information, clinical practice improvement activities. The composite performance score is compared to an annual threshold that is set by the CMS and decides either a positive, negative or neutral payment adjustment. Under MIPS, payment adjustments start from 4% as of 2019 and eventually increase to 9% by 2022.

What needs to be reported for MIPS?

MIPS reporting depends on four performance categories. Eligible Clinicians will be given a composite score according to their performance. Performance criteria include:

The following two criteria categories are required to be reported for the full calendar year.

  • Quality:checks the quality of healthcare services, depending upon the measures concerning healthcare quality and outcomes of care. Quality holds 50% of the MIPS composite score.
  • Cost:Also measures the cost of the care provided, which is computed by CMS according to the EP’s Medicare claim data. Cost holds 10% of the MIPS composite score.

The other two categories are:

  • Advancing Care Information (ACI):It holds 25% of the MIPS composite score. ACI encourages the use of certified EHR technology to ensure modern-day patient care.
  • Clinical Practice Improvement Activities:It accounts for 15% of the MIPS composite score and encourages the ongoing improvement of clinical activities.
What are the incentives and penalties under MIPS?

As of the incentives, Eligible Professionals (EPs) can earn a progressive payment adjustment of about 5% on the Medicare Part B reimbursements according to their MIPS performance in 2018. EPs who neither participate nor meet the minimum performance thresholds will be given a -5% payment adjustment. Each year, positive and negative adjustments are scheduled for the program, and bonus rewards are given to the highest scoring EPs.

Are there any Exemptions under MIPS?

The exemptions under MIPS are:

  • Providers in their first year with Medicare.
  • Providers with a low volume of Medicare payments less than $30,000 Medicare Part B or patients less than 100.
  • Providers who are under Advanced APMs.

This article is a go-to guide for understanding MACRA and MIPS EHR certification criteria. We hope it will offer helpful insight to those looking to find out the basic details about MACRA and MIPS.

Comparison of Medical Billing Rates

Comparison of Medical Billing Rates

Medical billing services charge their clients by three methods:

The percentage basis is generally used by medical insurance billers (MIBs) who do full-practice management or a combination of patient billing and claims billing, and just as it sounds, the MIB charges the provider a percentage of the money they collect per month as opposed to the amount of money they bill.

Follow is the review of some of the top medical billing services to help about how the prices differ from one company to the next.

Drchrono

  • Softwarefinder rating: 4/5
  • Best Medical Billing Service for Small Practices
  • Focused on smaller practices of 1 – 15 providers. Typically charges 4% to 8% of net collections.

CareCloud

  • Softwarefinder rating: 4/5
  • Best Low-Cost Medical Billing Service
  • Offers three tiers of services. Typically charges 3% to 7% of net collections.

AdvancedMD

  • Softwarefinder rating: 4/5
  • Best Medical Billing Service for Large Practices
  • Offers three tiers of services. Typically charges 3% to 7% of net collections.

DrChrono

DrChrono’s medical billing service is geared toward small and midsize practices, primarily in the range of one to 15 providers or 16 to 25 providers.

The company works with practices across all specialties, charging a percentage of their clients’ net collections.

DrChrono boasts a competitive first-pass claims rate of 97%, meaning only 3% of the claims its billers submit are denied by payers and require additional work and resubmission.

Besides, DrChrono’s percentage of collections includes access to its electronic medical records (EMR) software and practice management software.

DrChrono’s billing team starts the revenue cycle management process from the very beginning, generating claims by entering charges and coding them properly based on clinical documentation from the practice.

Once the claims are generated, DrChrono scrubs each one for common errors that would lead to rejection by the payers. If any errors are flagged, the company’s medical billers and coders revise the claim accordingly before submission.

The only drawback is that clients are required to use both the EMR and practice management software, whereas most medical billing services only require clients to use their practice management system.

CareCloud

CareCloud’s medical billing service has three different tiers, each of which offers a different scope of service for practices with different billing needs.

Concierge:

With Concierge, CareCloud will take over the claims submission and denial management process, getting claims to the appropriate payers promptly and then monitoring for any rejections. If a claim is rejected, CareCloud’s billing team will work to revise and resubmit the claim as needed.

Concierge Plus:

The second tier is similar to the first, except CareCloud adds a claims scrubbing step to the process. Using its rules engine, CollectiveIQ, CareCloud checks each claim against a database of more than 120 million common errors. If a potential mistake is flagged, its billing team will more closely review that claim before submission.

Concierge Pro:

Concierge Pro is CareCloud’s full revenue cycle management tier of service. CareCloud will access clinical documentation from the practice to generate claims by performing charge entry and coding services. Once created, those claims are put through the CollectiveIQ claims scrubbing system and adjusted if needed. Once scrubbed, the claims are submitted through the appropriate clearinghouse or directly to the proper payer. CareCloud billers will follow up on unpaid claims and work any denials to the point of payment.

CareCloud offers both a proprietary electronic health records (EHR) system and practice management software. Revenue cycle management clients must use CareCloud’s practice management platform because all billing is performed through that system. Use of the company’s EHR software is optional, although it is included in the price of the billing service.

The main limitation we discovered with CareCloud is its significant setup fees, which are steep compared to other medical billing services we reviewed. Even among companies that do charge setup fees, CareCloud is the most expensive. While these fees are one-time costs incurred during onboarding, they can become a significant upfront expense, especially for a practice on a tight budget.

AdvancedMD

AdvancedMD’s medical billing service is capable of handling all the revenue cycle management for large and small practices alike.

The company excels in managing billing for practices in the 100-provider space, making it best for medical billing service for large practices.

AdvancedMD’s outsourced revenue cycle management comes with access to its electronic medical record (EMR) software and practice management platform for a monthly percentage of clients’ net collections.

Currently, AdvancedMD boasts an organization-wide first-pass claims rate of 98.4%, which is one of the highest of the services we reviewed.

The company will also contractually guarantee a minimum first-pass claims rate of 95% for all clients, and it is the only company we reviewed that provides such a guarantee.

AdvancedMD begins the billing process after the charge entry and coding phase has already been completed. AdvancedMD does not perform charge entry or coding services at all so that responsibility falls on the practice to complete in-house or outsource to a third party.

Currently, the organization-wide first-pass claims rate for AdvancedMD is 98.4%, which is one of the highest rates. That means only 2.6% of claims submitted by AdvancedMD are denied by payers.

AdvancedMD’s pricing model takes into account a variety of factors, including practice size, the number of claims submitted, the number of patient encounters, the specialty and the complexity of the billing process.

Monthly collections:

The ultimate price will be the higher of a monthly minimum (set during contract negotiation) or a percentage of your monthly collections, so to offer a precise quote AdvancedMD needs to know how much your practice brings in per month.

Patient encounters:

Pricing will also depend on the number of total patients seen by physicians.

Specialty:

Because the billing process and specific rules can vary so much from specialty to specialty, AdvancedMD incorporates the complexity of your specialty into the final percentage.

The number of providers:

Finally, your total number of providers can also influence the quote.

AdvancedMD’s largest limitation is the fact that it does not manage charge entry or the coding of claims. These are important aspects of the medical billing process that require experienced, certified coders to perform properly.